Abstract
The purpose of this study was to retrospectively determine the local control rate and contributing factors to local progression after computed tomography (CT)-guided radiofrequency ablation (RFA) for unresectable lung tumor. This study included 138 lung tumors in 72 patients (56 men and 16 women; age 70.0 ± 11.6 years (range 31–94); mean tumor size 2.1 ± 1.2 cm [range 0.2–9]) who underwent lung RFA between June 2000 and May 2009. Mean follow-up periods for patients and tumors were 14 and 12 months, respectively. The local progression-free rate and survival rate were calculated to determine the contributing factors to local progression. During follow-up, 44 of 138 (32%) lung tumors showed local progression. The 1-, 2-, 3-, and 5-year overall local control rates were 61, 57, 57, and 38%, respectively. The risk factors for local progression were age (≥70 years), tumor size (≥2 cm), sex (male), and no achievement of roll-off during RFA (P < 0.05). Multivariate analysis identified tumor size ≥2 cm as the only independent factor for local progression (P = 0.003). For tumors <2 cm, 17 of 68 (25%) showed local progression, and the 1-, 2-, and 3-year overall local control rates were 77, 73, and 73%, respectively. Multivariate analysis identified that age ≥70 years was an independent determinant of local progression for tumors <2 cm in diameter (P = 0.011). The present study showed that 32% of lung tumors developed local progression after CT-guided RFA. The significant risk factor for local progression after RFA for lung tumors was tumor size ≥2 cm.
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Dupuy DE, Zagoria RJ, Akerley W, Mayo-Smith WW, Kavanagh PV, Safran H (2000) Percutaneous radiofrequency ablation of malignancies in the lung. AJR Am J Roentgenol 174:57–59
Hiraki T, Tajiri N, Mimura H et al (2006) Pneumothorax, pleural effusion, and chest tube placement after radiofrequency ablation of lung tumors: incidence and risk factors. Radiology 241:275–283
Okuma T, Matsuoka T, Yamamoto A et al (2008) Computed tomography-guided re-radiofrequency ablation for unresectable lung tumors with local progression previously treated with the same procedure. Radiat Med 26:519–525
Steinke K, King J, Glenn D et al (2003) Radiologic appearance and complications of percutaneous computed tomography-guided radiofrequency-ablated pulmonary metastases from colorectal carcinoma. J Comput Assist Tomogr 27:750–757
Hiraki T, Sakurai J, Tsuda T et al (2006) Risk factors for local progression after percutaneous radiofrequency ablation of lung tumors: evaluation based on a preliminary review of 342 tumors. Cancer 107:2873–2880
Simon CJ, Dupuy DE, DiPetrillo TA et al (2007) Pulmonary radiofrequency ablation: long-term safety and efficacy in 153 patients. Radiology 243:268–275
de Baere T, Palussiere J, Auperin A et al (2006) Midterm local efficacy and survival after radiofrequency ablation of lung tumors with minimum follow-up of 1 year: prospective evaluation. Radiology 240:587–596
Lencioni R, Croceti L, Cioni R et al (2008) Response to radiofrequency ablation of pulmonary tumours: a prospective, intention-to-treat, multicentre clinical trial (the RAPUTURE study). Lancet Oncol 9:621–628
Yamakado K, Hase S, Matsuoka T et al (2007) Radiofrequency ablation for the treatment unresectable lung metastases in patients with colorectal cancer: a multicenter study in Japan. J Vasc Interv Radiol 18:393–398
Okuma T, Matsuoka T, Tutumi S, Nakmura K, Inoue Y (2007) Air embolism during needle placement for CT-guided radiofrequency ablation of an unresectable metastatic lung lesion. J Vasc Interv Radiol 18:1592–1594
Okuma T, Okamura T, Matsuoka T et al (2006) Fluorine-18-fluorodeoxyglucose positron emission tomography for assessment of patients with unresectable recurrent or metastatic lung cancers after CT-guided radiofrequency ablation: preliminary results. Ann Nucl Med 20:115–121
Higaki F, Okamura Y, Sato S et al (2008) Preliminary retrospective investigation of FDG-PET/CT timing in follow up of ablated lung tumor. Ann Nucl Med 22:157–163
Yan TD, King J, Sjarif A et al (2007) Treatment failure after percutaneous radiofrequency ablation for nonsurgical candidates with pulmonary metastases from colorectal carcinoma. Ann Surg Oncol 14:1718–1726
Gillams AR, Lees WR (2008) Radiofrequency ablation of lung metastases: factors influencing success. Eur Radiol 18:672–677
Okada M, Nishio W, Sakamoto T et al (2005) Effect of tumor size on prognosis in patients with non-small cell lung cancer: the role of segmentectomy as a type of lesser resection. J Thorac Cardiovasc Surg 129:87–93
Yamato Y, Koike T, Yoshiya K, Shinohara H, Toyabe S (2008) Results of surgical treatment for small (2 cm or under) adenocarcinoma of the lung. Surg Today 38:109–114
Ambrogi MC, Lucchi M, Dini P et al (2006) Percutaneous radiofrequency ablation of lung tumours: results in the mid-term. Eur J Cardiothorac Surg 30:177–183
Lin SM, Lin CJ, Chung HJ, Hsu CW, Peng CY (2003) Power roll-off during interactive radiofrequency ablation can enhance necrosis when treating hepatocellular carcinoma. AJR Am J Roentgenol 180:151–157
Koike T, Yamato Y, Yoshiya K, Shimoyama T, Suzuki R (2003) Intentional limited pulmonary resection for peripheral T1 N0 M0 small-sized lung cancer. J Thorac Cardiovasc Surg 125:924–928
Hiraki T, Gobara H, Mimura H et al (2009) Does tumor type affect local control by radiofrequency ablation in the lungs? Eur J Radiol. Feb 19 [Epub ahead of print]
Yamamoto A, Nakamura K, Matsuoka T et al (2005) Radiofrequency ablation in a porcine lung model: correlation between CT and histopathologic findings. AJR Am J Roentgenol 185:1299–1306
Ginsberg RJ, Rubenstein LV (1995) Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Ann Thorac Surg 60:615–622
Hiraki T, Gobara H, Takemoto M et al (2006) Percutaneous radiofrequency ablation combined with previous bronchial arterial chemoembolization and followed by radiation therapy for pulmonary metastasis from hepatocellular carcinoma. J Vasc Interv Radiol 17:1189–1193
Anai H, Uchida BT, Pavcnik D et al (2006) Effects of blood flow and/or ventilation restriction on radiofrequency coagulation size in the lung: an experimental study in swine. Cardiovasc Intervent Radiol 29:838–845
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Okuma, T., Matsuoka, T., Yamamoto, A. et al. Determinants of Local Progression After Computed Tomography-Guided Percutaneous Radiofrequency Ablation for Unresectable Lung Tumors: 9-Year Experience in a Single Institution. Cardiovasc Intervent Radiol 33, 787–793 (2010). https://doi.org/10.1007/s00270-009-9770-9
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DOI: https://doi.org/10.1007/s00270-009-9770-9